基于内脏高敏感从脾阳不足论述腹泻型肠易激综合征临床症状

腹泻型肠易激综合征(IBS-D)是一类易受饮食、生活环境及心理精神影响,以腹痛或腹部不适及腹泻为主要临床表现的功能性胃肠疾病。其机制仍在探索中,但内脏敏感性增高被认为是导致IBS-D发生的核心机制,其主要体现为感觉异常或阈值下降,即低于一般刺激时患者易出现腹痛、腹部不适及腹泻的症状。目前中医上对IBS-D患者病因病机认识尚有争议,但该病本于脾虚,病久导致脾肾阳虚的病机是公认的。结合二者临床特点及相关研究,推测脾肾阳虚型IBS-D的临床表现与内脏高敏感密切相关。

IBS-D clinical symptoms from deficiency of spleen yang based on visceral hypersensitivity

Diarrhea-predominant irritable bowel syndrome(IBS-D)is a kind of functional gastrointestinal diseases which are easily influenced by diet,living environment and psychological spirit,and whose main clinical manifestations are abdominal pain or abdominal discomfort and diarrhea.Its mechanism is still not clear,but the increased visceral sensitivity is considered as the core factor,which is mainly manifested by abnormal sensation or lower threshold.Therefore,patients are more likely to suffer from lower stimulation than regular condition.At present, the etiology and pathogenesis of IBS-D are still controversial in traditional Chinese medicine,but it is generally recognized that long-term illness leads to spleen-kidney yang deficiency in IBS-D patients based on spleen deficiency.Combined with the clinical characteristics and related research,it is speculated that the clinical manifestations of IBS-D with spleen-yang deficiency are closely related to visceral hypersensitivity.